Health care costs and Medicaid

Thursday

Jul 11, 2013 at 12:01 AM

A few montha ago, Arkansas became the first state in the nation to adopt bi-partisan legislation that will permit low-income residents to use federal Medicaid dollars to purchase private health-care insurance.

Bill Downs

A few montha ago, Arkansas became the first state in the nation to adopt bi-partisan legislation that will permit low-income residents to use federal Medicaid dollars to purchase private health-care insurance. State Representative Richard Womack of Arkadelphia, however, had his doubts about passing the so-called private option, and wasn’t afraid to express them. During a break, I asked him why he had voted against it.

Womack: “My biggest concern was that we still do not know what the individual premium price is per person, which is the number that this entire plan hinges on. And there’s a legitimate reason for not having it yet and that is because the bids are not in. But I asked over and over why we could not wait until the bids are in, presumably in May, when we know the numbers that we are committing our state to? It makes a lot of sense to me.”

Downs: Why do you say that?

Womack: I asked every sponsor of the bill, including the Governor’s office, at least two or three times, just tell me why we can’t wait. I understand why we don’t have the number today, but I don’t understand why we can’t wait until we know what we’re committing ourselves to. I even went so far as to ask David Sanders, in particular, if he would put an amendment on the bill that if it didn’t come in within a reasonable range, we’re out of the deal on the front end before we’re too far in.

Downs: How many people in Clark County will be under this plan?

Womack: I have been told that there are 2,300 families in Clark County who will be eligible. But, unfortunately it’s going to affect every citizen because it has been established that even those who buy their own insurance will have increased premium rates. And people who have really high deductible policies will not be allowed to do that anymore. It affects everybody.

Downs: How will this law protect the taxpayers from fraud, waste and abuse?

Womack: Well, I don’t think this law will do that. A part of the grand bargain, however, was the passage of several new laws that apply to Medicaid—an example being the smart chip, a card with a photo ID, issued to parents to prevent fraudulent use of insurance cards.

Downs: What do small businesses say about this?

Womack: On the front end, the Private Option is definitely a boost to small businesses. One of the amendments we dealt with makes it explicit in law—it was already implicit in the bill—that those business owners were not liable for any fines or penalties that would be assessed with it. So, short term, it’s gonna be a boost for most all employers.

Downs: Since it is now law, can we agree that it may actually work to the advantage of the taxpayers in Arkansas?

Womack: Oh, I think it will work short term. My whole problem with this is that we don’t know what the private option is going to cost per person. The entire plan hinges on those numbers coming in where they expect it to. If this doesn’t happen, then everything we’ve talked about suddenly becomes irrelevant.

Downs: A common criticism of Republicans is that they are the party of “No!” Is there a way we can work in cooperation with the “other side” to achieve the common good?

Womack: Oh, I think so. I believe if this had been handled a little slower, the numbers would have been drastically different. I don’t think I’m alone in my reason for voting against this bill. In all honesty, I want to be on board with this plan. If it works out like it’s being sold, it is the best deal for Arkansas, but the fact is: we don’t know yet. We don’t have a number to work with. And that was my biggest holdup. I just could not feel good potentially signing the state up for billions of dollars that we have no way to cover. I didn’t have my mind made up until they refused to wait until we knew what numbers we were voting on. That’s when I took my NO position.

Downs: What is the difference in the private option and all out Obamacare?

Womack: Theoretically, the private market can operate much more efficiently than any federal program and I agree wholeheartedly with that! In my view, the problem is anytime something is given instead of earned, it has far less value. So, I don’t know if [the Private Option] will be respected and treated as it should be, which may make the efficiency of the private market null and void. If the private option is suddenly abused, however, it would do away with what the private market might have provided.

Downs: So what is the next step?

Womack: The next step, as I understand it, is to wait for the bids to come in from the four to six different insurance companies that will bid on the pool.